2022-05-11T13:19:39-05:00 2021-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2020-07-01 362192824 LUTHERAN HOME FOR THE AGED INC LUTH 8473687342 800 W OAKTON STREET ARLINGTON HEIGHTS IL 600044602 JAMES BUCKMAN CFO 8473687365 2022-05-11 1 JAMES BUCKMAN 999009999 CHRIS MANDERFIELD P01238973 6305738600 2022-05-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SLOAN BENTLEY 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 46009976 0 X WWW.LUTHERANLIFECOMMUNITIES.ORG X 1892 IL SEE SCHEDULE O FOR ORGANIZATION MISSION STATEMENT. EMPOWERING VIBRANT GRACE FILLED LIVING ACROSS ALL GENERATIONS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FINANCIAL FUNDS. 3 0 641 200 0 0 593208 2481980 50864957 42945907 1797089 111148 803776 470941 54059030 46009976 0 0 0 0 24829862 22404456 0 0 0 22801072 23074805 47630934 45479261 6428096 530715 133389832 131494614 115252606 111509913 18137226 19984701 EMPOWERING VIBRANT GRACE FILLED LIVING ACROSS ALL GENERATIONS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FINANCIAL FUNDS. 0 0 37400424 43328277 DEVELOPMENT AND OPERATION OF 376 SKILLED NURSING UNITS AND 100 ASSISTED LIVING BEDS FOR SENIORS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FUNDS. 37400424 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 77 0 641 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X LUTHERAN LIFE MINISTRIES 8473687365 3150 SALT CREEK LANE ARLINTON HEIGHTS IL 60005 SLOAN BENTLEY CHAIR/CEO (STARTED 9/14/22) 2.00 35.50 X X 0 134257 2843 JOHN COUTURE VICE CHAIR (STARTED 3/8/21) 2.00 35.50 X X 0 24615 0 JAMES BUCKMAN TREASURER/SECRETARY (STARTED 3/8/21) 2.00 35.50 X X 0 157274 18330 MICHAEL RENETZKY CHAIR/INTERIM CEO (UNTIL 9/14/20) 1.00 19.00 X X 0 0 0 LORI J SMITH VICE-CHAIR (UNTIL 2/5/21) 2.00 35.50 X X 0 349448 4898 MARIE D CARLSON-KYLLO TREASURER/SECRETARY (UNTIL 1/15/21) 2.00 35.50 X X 0 309181 27831 JENNIFER MCKOWN DIRECTOR OF NURSING (UNTIL 4/1/21) 37.50 X 124639 0 20086 ANDREW KAZMIERCZAK EXECUTIVE DIRECTOR (UNTIL 3/3/21) 37.50 X 198088 0 33152 SARAH KURTH ADMINISTRATOR 37.50 X 179824 0 34366 KELLY STEGALL HR DIRECTOR (UNTIL 4/7/21) 37.50 X 115471 0 12904 ANGELA ZAMORA CORPORATE DIR. OF CULINARY SERV. 37.50 X 131562 0 9911 749584 974775 164321 6 0 1 0 SELECT REHABILITATION PO BOX 71985 CHICAGO IL 60694 THERAPY SERVICES 3590488 CHUHAK & TECSON PC 30 S WACKER DRIVE 26TH FLOOR CHICAGO IL 60606 LEGAL 461420 FAMILY'S ANGEL HOME CARE SERVICES INC 550 FRONTAGE ROAD SUITE 2765 NORTHFIELD IL 60093 HOME CARE SERVICES 239371 BRIGHTVIEW LANDSCAPES LLC PO BOX 740655 ATLANTA GA 30374 LANDSCAPING 204284 GREATCALL INC PO BOX 207312 DALLAS TX 75320 SENIOR CELL PHONES AND MEDICAL ALERT DEV 199397 12 234148 2247832 2481980 RESIDENT SERVICE REVENUE 623000 42945907 42945907 42945907 111148 111148 88571 0 88571 88571 88571 CAFETERIA INCOME 623000 230406 230406 PURCHASE DISCOUNTS 623000 83005 83005 MISCELLANEOUS 623000 49500 49500 19459 19459 382370 46009976 43328277 0 199719 18636521 16938981 1697540 215303 196165 19138 2219794 1772431 447363 1332838 1255740 77098 3538874 3538874 235518 235518 37035 37035 1981974 1857434 124540 303171 302051 1120 481171 270944 210227 152427 152427 1525062 1525062 23634 25449 -1815 936 936 4536523 4536523 4007348 4007348 1692148 1692148 MEDICAL SUPPLIES 1331017 1331017 COVID-19 EXPENSE 1295754 1295754 FOOD & DIETARY SUPPLIES 1233206 1233206 GROUND MAINTENANCE & RE 609375 609375 89632 89581 51 45479261 37400424 8078837 0 3700804 6714468 3828730 3743428 5047382 4049277 2865557 2679183 138838 166709 1319798 1503286 146957820 71810295 79419846 75147525 134340 134340 36934537 37356398 133389832 131494614 3752738 4744707 94856363 94034762 2479567 2328636 10047519 9177876 4116419 1223932 115252606 111509913 X 18137226 19984701 18137226 19984701 133389832 131494614 X 530715 1316760 X 0 1 X 1 1 1 X 400042 383595 69749 593208 2481980 3928574 51367834 53498139 56249914 50864957 42945907 254926751 51767876 53881734 56319663 51458165 45427887 258855325 0 0 0 258855325 1403620 23526948 823431 383428 199719 26337146 1403620 23526948 823431 383428 199719 26337146 922317 841159 731968 696576 382370 3574390 54093813 78249841 57875062 52538169 46009976 288766861 0.89640 0.88120 0.09120 0.10470 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME CAFETERIA MISCELLANEOUS DISCOUNTS ETC - 2016 AMOUNT: $ 922,317. 2017 AMOUNT: $ 841,159. 2018 AMOUNT: $ 731,968. 2019 AMOUNT: $ 696,576. 2020 AMOUNT: $ 382,370. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 20225 20225 120866453 48112897 72753556 24408665 22979295 1429370 1662477 718103 944374 75147525 ASSETS HELD BY TRUSTEE UNDER BOND INDENTURE 6478082 OTHER ASSETS 8661 DUE FROM AFFILIATES 30709626 RESIDENT DEPOSITS 160029 37356398 RESERVE FOR FUNERAL EXPENSES 6400 FUNDS WITHHELD FROM EMPLOYEES FOR RESIDENT NEEDS 22409 FAIR MARKET VALUE INTEREST RATE SWAP 1195124 REFUNDABLE ADVANCE -1 1223932 X PART IV, LINE 2B: ESCROW LIABILITIES REPRESENT RESIDENT DEPOSITS AND RESIDENT PERSONAL FUND LIABILITIES. PART X, LINE 2: THE CORPORATION QUALIFIES AS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION HAS ADOPTED ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE COMBINED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, THE CORPORATION MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. THE CORPORATION DOES NOT HAVE AN ASSET OR LIABILITY FOR UNRECOGNIZED TAX BENEFITS. X X X X 0 0 0 0 0 0 0 0 0 JAMES BUCKMAN TREASURER/SECRETARY (STARTED 3/8/21) 0 157166 0 108 0 0 0 2942 0 15388 0 175604 0 0 LORI J SMITH VICE-CHAIR (UNTIL 2/5/21) 0 314448 0 35000 0 0 0 4898 0 0 0 354346 0 0 MARIE D CARLSON-KYLLO TREASURER/SECRETARY (UNTIL 1/15/21) 0 289181 0 20000 0 0 0 5657 0 22174 0 337012 0 0 ANDREW KAZMIERCZAK EXECUTIVE DIRECTOR (UNTIL 3/3/21) 179227 0 18861 0 0 0 3839 0 29313 0 231240 0 0 0 SARAH KURTH ADMINISTRATOR 162689 0 17135 0 0 0 3539 0 30827 0 214190 0 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45204E6F0 2019-12-12 78608074 REFINANCE PREVIOUS BONDS AND FUND FUTURE CAPITAL EXPENDITURES 0 0 0 A 322003 78608074 4996541 1304925 4817757 67488851 2012 1 0 1 1 A 0 1 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 10 THE SERIES 2019 BONDS AS SHOWN ABOVE WERE ISSUED VIA AN OBLIGATED GROUP WHICH INCLUDES THE FOLLOWING ENTITIES: LUTHERAN HOME AND SERVICES FOR THE AGED, INC., LUTHERAN HOME FOR THE AGED, INC., LUTHER OAKS, INC., WITTENBERG LUTHERAN VILLAGE, INC., WITTENBERG LUTHERAN ENDOWMENT CORPORATION, AND PLEASANT VIEW LUTHER HOME, INC. AMOUNTS DISCLOSED ON PART II, LINE 10, WERE CALCULATED BASED ON THE PRORATED PORTION OF THE SERIES 2019 BOND ISSUANCE PRICE BENEFITING THE APPLICABLE ORGANIZATION (AS DISCLOSED WITHIN FORM 8038 FILED IN CONNECTION WITH THE SERIES 2019 BONDS). THESE AMOUNTS ARE ESTIMATES OF THE FUTURE CAPITAL EXPENDITURES TO BE INCURRED BY MEMBERS OF THE OBLIGATED GROUP. THE CUMULATIVE AMOUNT OF FUTURE CAPITAL EXPENDITURES FOR THE OBLIGATED GROUP TOTALS $10,000,000 AND HAS BEEN ALLOCATED ACROSS THE OBLIGATED GROUP CONSISTENT WITH THE ALLOCATION OF THE BOND ISSUE PRICE FROM FORM 8038. FORM 990, PART VI, SECTION A, LINE 6 LUTHERAN HOME AND SERVICES FOR THE AGED, INC. IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD IS APPOINTED BY THE SOLE CORPORATE MEMBER, LUTHERAN HOME AND SERVICES FOR THE AGED, INC. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE CORPORATE MEMBER, LUTHERAN HOME AND SERVICES FOR THE AGED, INC. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION REVIEWS THE TAX RETURN WITH THE AUDIT COMMITTEE OF LUTHERAN LIFE MINISTRIES,(THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) TO REPORT TO THE BOARD OF LUTHERAN LIFE MINISTRIES, WHICH PROVIDES FINAL APPROVAL OF THE TAX RETURNS OF ALL SUBSIDIARIES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS, DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE TO THE BOARD OF DIRECTORS WHEN A CONFLICT MAY EXIST. THE POLICY AND COMPLIANCE WITH THIS POLICY ARE REVIEWED ANNUALLY BY THE AUDIT COMMITTEE OF ITS PARENT LUTHERAN LIFE MINISTRIES(WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED WITH THE HELP OF AN INDEPENDENT COMPENSATION CONSULTANT AND THE COMPENSATION COMMITTEE OF LUTHERAN LIFE MINISTRIES (WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) ULTIMATE APPROVAL FOR THE COMPENSATION AMOUNT FOR THE CEO RESTS WITH THE BOARD OF LUTHERAN LIFE MINISTRIES. THE LUTHERAN LIFE MINISTRIES BOARD PROVIDES COUNSEL TO THE CEO FOR THE COMPENSATION OF ANY OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE TAX RETURN, FINANCIAL STATEMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR MARKET VALUE OF INTE 1,316,760. LUTHERAN HOME AND SERVICES FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363375902 HOUSING AND SERVICES FOR SENIORS IL 501(C)(3) 509(A)(3) LUTHERAN LIFE MINISTRIES 0 LUTHERAN COMMUNITY SERVICES FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363365609 IMPROVE QUALITY OF LIFE FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN FOUNDATION FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363365615 SUPPORTS THE WORK PROVIDED IN THE LUTHERAN HOME AND SERVICES SYSTEM IL 501(C)(3) 170(B)(1)(A)(VI) LUTHERAN LIFE MINISTRIES 0 LUTHER OAKS INC 601 LUTZ ROAD BLOOMINGTON IL 61704 202117469 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 WITTENBERG LUTHERAN VILLAGE INC 1200 E LUTHER DRIVE CROWN POINT IN 46307 351299499 LONG-TERM HEALTH CARE FACILITY IN 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 WITTENBERG LUTHERAN VILLAGE ENDOWMENT CORPORATION 1200 E LUTHER DRIVE CROWN POINT IN 46307 351472245 LONG-TERM HEALTH CARE FACILITY IN 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE MINISTRIES 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 203426654 DEVELOP NEW SERVICES FOR SENIORS AND MANAGE SENIOR LIVING FACILITIES IL 501(C)(3) 509(A)(3) N/A 0 PLEASANT VIEW LUTHERAN HOME INC 505 COLLEGE AVENUE OTTAWA IL 61350 362167830 NURSING AND HEALTHCARE FACILITY IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE COMMUNITIES FOUNDATION 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 363861882 SUPPORTS THE RESIDENTS AND OPERATIONS OF EACH LUTHERAN LIFE COMMUNITY IL 501(C)(3) 509(A)(1) LUTHERAN LIFE MINISTRIES 0 ST PAUL'S HOUSE AND HEALTH CARE CENTER 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 362167897 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE COMMUNITIES 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 208549333 MANAGEMENT SERVICES IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 ARLINGTON OF NAPLES 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 262019353 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 LUTHERAN LIFE COMMUNITIES FOUNDATION E 6432613 LUTHERAN HOME AND SERVICES FOR THE AGED INC D 35495429 WITTENBERG LUTHERAN VILLAGE INC D 333989 PLEASANT VIEW LUTHER HOME INC D 172378 LUTHER OAKS INC D 112802 LUTHERAN LIFE COMMUNITIES FOUNDATION C 234148 LUTHERAN LIFE COMMUNITIES O 3538874 LUTHERAN LIFE COMMUNITIES E 120976